LEGS: Laparoscopy in Emergency General Surgery

Transcription

1 LEGS: Laparoscopy in Emergency General Surgery A UK Survey - Version 5 North West Research Collaborative INSTRUCTIONS FOR COMPLETION Please print out this questionnaire and complete ALL questions Once completed, the designated trainee for your site will input the data into the REDCap database PLEASE NOTE: IT IS NOT POSSIBLE TO ENTER A QUESTIONNAIRE INTO THE DATABASE IF ANY DATA FIELDS ARE LEFT BLANK Thank you very much for your time

2 Section A This section seeks to evaluate details about your training and experience of elective laparoscopic surgery. 1. In which year did you attain your primary medical qualification? (e.g. MBBS/MBChB) 2. In which year did you begin your first consultant post? 3. In which subspecialty do you work? 4. In which region did you complete your training? Eastern Oxford Kent, Surrey & Sussex Scotland Leicestershire, Northamptonshire & South Western Rutland London South Yorkshire and South Humber Mersey Wales Northern West Midlands Northern Ireland Wessex North West Yorkshire Trent 5. Did you complete a fellowship as part of your training? If yes, please provide details of nature of fellowship and duration. Yes No

3 6. Which region do you currently work in? Eastern Kent, Surrey & Sussex Leicestershire, Northamptonshire & Rutland London Mersey Northern Northern Ireland North West Trent Oxford Scotland South Western South Yorkshire and South Humber Wales West Midlands Wessex Yorkshire 7. Are you aware that all laparoscopic emergency cases (excluding appendix and gallbladder surgery) should be entered into the National Emergency Laparotomy Audit (NELA) database? Yes No 8. Do you routinely include emergency laparoscopic emergency cases in your NELA data? Yes No 9A. In the year from 1 st January 2016 to 31 st December 2016, how many of the following procedures did you perform laparoscopically? Procedure Quantity >30 Cholecystectomy Inguinal Hernia Other abdominal hernia Gastrectomy Oesophagectomy Hepatic resection Pancreaticoduodenectomy Nissen s Fundoplication Right Hemicolectomy Anterior Resection Abdominoperineal Resection Subtotal Colectomy

4 9B. If there are any other procedures you perform laparoscopically, please could you list them below and indicate the approximate number you have performed. Procedure Quantity Please add free text comments in the box below:

5 Section B This section seeks to evaluate which emergency procedures you perform laparoscopically. How often would you initially approach the following procedures laparoscopically? Please enter any comments at the end. 1. Appendicectomy 2. Cholecystectomy 3. Perforated duodenal or gastric ulcer 4. Perforated diverticulum (Hinchey Grade 3) 5. Perforated diverticulum (Hinchey Grade 4) 6. Small bowel perforation 7. Colonic cancer causing bowel obstruction

6 8. Adhesional small bowel obstruction 9. Small bowel obstruction due to a small bowel lesion 10. Incarcerated inguinal hernia 11. Strangulated inguinal hernia 12. Ischaemic bowel (colon/small bowel) Subtotal colectomy for refractory colitis Please add free text comments in the box below:

7 Section C This section seeks to examine factors affecting your decision to perform laparoscopic surgery. Please select your level of agreement with the following statements: 1. I am less likely to perform emergency laparoscopic procedures in patients with higher BMIs Nor 2. I am less likely to perform emergency laparoscopic surgery in the elderly Nor 3. I am less likely to perform emergency laparoscopic procedures in patients who have had previous abdominal surgery Nor 4. I am less likely to perform emergency laparoscopic procedures in patients who have poorer performance statuses Nor

8 5. I am less likely to perform emergency laparoscopic procedures in patients who have high ASA grades Nor 6. I am less likely to perform emergency laparoscopic procedures in frail patients Nor 7. I am less likely to perform emergency laparoscopic procedures in patients who are returning to theatre for management of complications from a recent operation Nor 8. I am less likely to perform emergency laparoscopic procedures during the hours of 8pm-8am Nor 9. I am less likely to perform emergency laparoscopic procedures at weekends Nor

9 Are there any other factors that you take into consideration on deciding your approach? Please add free text comments in the box below.

10 Section D This section seeks to evaluate your surgical practice in a number of different emergency scenarios. Please choose how often you would approach the procedure laparoscopically for each scenario. Question 1 A patient with suspected appendicitis. They have no significant comorbidities. You decide to operate. How likely are you to approach this laparoscopically? a) 6 year old female b) 12 year old male c) 25 year old female d) 65 year old male

11 Question 2 - A 50 year male with a CT diagnosed perforated duodenal ulcer. You decide to operate. How likely are you to approach this laparoscopically? a) No significant co-morbidities b) ASA grade 3 c) BMI 42 d) Previous abdominal surgery e) Evidence of small bowel dilatation on CT scan

12 Question 3 - A 60 year old female with Hinchey grade 3 diverticulitis diagnosed on CT scan. You decide to operate. How likely are you to approach this laparoscopically? a) No significant co-morbidities b) ASA grade 3 c) BMI 42 d) Previous abdominal surgery e) Evidence of small bowel dilatation on CT scan

13 Question 4 - A 60 year old female with Hinchey grade 4 diverticulitis diagnosed on CT scan. You decide to operate. How likely are you to approach this laparoscopically? a) No significant co-morbidities b) ASA grade 3 c) BMI 42 d) Previous abdominal surgery e) Evidence of small bowel dilatation on CT scan

14 Question 5 You have performed a laparoscopic repair of a perforated duodenal ulcer. Two days later the patient deteriorates on the ward. A CT scan shows a large amount of free fluid and free air. You decide to operate. How likely are you to approach this laparoscopically? a) No significant co-morbidities b) ASA grade 3 c) BMI 42 d) 50 year old male e) 80 year old male

15 Question 6 A patient has had a laparoscopic anterior resection 4 days ago (primary anastomosis and NOT defunctioned). Today they have deteriorated and a CT scan shows a probable leak at the anastomosis. You decide to operate. How likely are you to approach this laparoscopically? a) No significant co-morbidities b) ASA grade 3 c) BMI 42 d) 50 year old male e) 80 year old male If you have any comments on the above sections, please enter them here:

16 Question 7 A patient presents with small bowel obstruction confirmed on a CT scan. They have had no previous surgery and the radiologist reports an abrupt transition point in the pelvis. You decide to operate. How likely are you to approach this laparoscopically? a) No significant co-morbidities b) ASA grade 3 c) BMI 42 d) 50 year old male e) 80 year old male f) A patient who has had previous open abdominal surgery If you have any comments on the above sections, please enter them here: